Dieetleer 1
Inhoudsopgave
1. Algemeen.................................................................................................................................................. 3
1.1. BMI.................................................................................................................................................................3
1.2. Energiebepaling.............................................................................................................................................3
2. Energie- en eiwitverrijkt dieet.................................................................................................................... 4
2.1. Begripsomschrijving en indicaties.................................................................................................................4
2.2. Screeningsmethoden.....................................................................................................................................5
2.3. Doelstellingen dieet.......................................................................................................................................5
2.4. Dieetkenmerken.............................................................................................................................................5
Energie..............................................................................................................................................................5
Eiwitten.............................................................................................................................................................5
Vetten en koolhydraten....................................................................................................................................6
Vitaminen en mineralen...................................................................................................................................6
Vocht en elektrolyten.......................................................................................................................................6
2.5. Praktische uitwerking en tips.........................................................................................................................6
Eiwitten.............................................................................................................................................................6
Vetten................................................................................................................................................................6
Koolhydraten.....................................................................................................................................................7
Vocht.................................................................................................................................................................7
3. Energiebeperkt dieet.................................................................................................................................. 8
3.1. Begripsomschrijving en indicaties.................................................................................................................8
3.2. Doelstellingen................................................................................................................................................8
3.3. Bepaling gewenste gewichtsvermindering....................................................................................................8
3.4. Dieetkenmerken.............................................................................................................................................9
Energie..............................................................................................................................................................9
Eiwitten.............................................................................................................................................................9
Vetten................................................................................................................................................................9
Koolhydraten.....................................................................................................................................................9
Vitaminen en mineralen...................................................................................................................................9
Voedingsvezels..................................................................................................................................................9
Vocht.................................................................................................................................................................9
3.5. Praktische uitwerking en tips.......................................................................................................................10
Vetten.............................................................................................................................................................10
Koolhydraten..................................................................................................................................................10
Alcohol............................................................................................................................................................10
Voedingsvezel.................................................................................................................................................10
Energieruilwaardesysteem.............................................................................................................................10
3.6. Very low calorie diets...................................................................................................................................10
4. Eiwitbeperkt dieet.................................................................................................................................... 11
4.1. Begripsomschrijving en indicaties...............................................................................................................11
4.2. Doelstellingen..............................................................................................................................................11
1
, 4.3. Dieetkenmerken...........................................................................................................................................11
Energie............................................................................................................................................................11
Eiwitten...........................................................................................................................................................11
Koolhydraten en vetten..................................................................................................................................12
Mineralen en spoorelementen.......................................................................................................................13
Vocht...............................................................................................................................................................13
4.4. Praktische uitwerking..................................................................................................................................13
5. Glutenvrij dieet........................................................................................................................................ 13
5.1. Begripsomschrijving en indicaties...............................................................................................................13
5.2. Doelstellingen..............................................................................................................................................13
5.3. Dieetprincipes..............................................................................................................................................14
5.4. Praktische uitwerking..................................................................................................................................14
6. Vetbeperkt dieet...................................................................................................................................... 15
6.1. Begripsomschrijving en indicaties...............................................................................................................15
6.2. Doelstellingen..............................................................................................................................................15
6.3. Dieetkenmerken...........................................................................................................................................15
Vetten.............................................................................................................................................................15
Calcium...........................................................................................................................................................15
Vetoplosbare vitaminen.................................................................................................................................15
7. MKT-dieet................................................................................................................................................ 15
7.1. Begripsomschrijving en indicaties...............................................................................................................15
7.2. Dieetkenmerken...........................................................................................................................................16
Vetten.............................................................................................................................................................16
Vetoplosbare vitaminen.................................................................................................................................16
8. Voedingsvezelverrijkt dieet....................................................................................................................... 16
8.1. Begripsomschrijving en indicaties...............................................................................................................16
8.2. dieetkenmerken...........................................................................................................................................17
Vezels..............................................................................................................................................................17
Vocht...............................................................................................................................................................17
8.3. Praktische uitwerking..................................................................................................................................17
9. Lactosevrij/lactosebeperkt dieet.............................................................................................................. 18
9.1. Begripsomschrijving en indicaties...............................................................................................................18
9.2. Dieetkenmerken...........................................................................................................................................18
Lactose............................................................................................................................................................18
Vitaminen en mineralen.................................................................................................................................18
9.3. Praktische uitwerking..................................................................................................................................19
Lactosebeperkt...............................................................................................................................................19
Lactosevrij.......................................................................................................................................................19
Galactosevrij...................................................................................................................................................19
10. Natriumbeperkt dieet............................................................................................................................. 19
10.1. Begripsomschrijving en indicaties.............................................................................................................19
10.2. doelstellingen.............................................................................................................................................19
2
, 10.3. Dieekenmerken..........................................................................................................................................20
10.4. Praktische uitwerking................................................................................................................................20
11. Kaliumbeperkt dieet............................................................................................................................... 20
11.1. Dieetkenmerken.........................................................................................................................................20
11.2. Praktische uitwerking................................................................................................................................20
12. Vochtbeperkt dieet................................................................................................................................. 20
12.1. Begripsomschrijving en indicaties.............................................................................................................20
12.2. Dieetkenmerken.........................................................................................................................................20
13. Fosfaatbeperkt dieet.............................................................................................................................. 21
13.1. Begripsomschrijving en indicaties.............................................................................................................21
13.2. Dieetkenmerken.........................................................................................................................................21
13.3. Praktische uitwerking................................................................................................................................21
14. Diagnostische diëten.............................................................................................................................. 22
14.1. Eliminatiediëten.........................................................................................................................................22
14.2. Proefdiëten................................................................................................................................................22
14.3. Voorbereidingsdiëten.................................................................................................................................22
Ca-beperkt dieet.............................................................................................................................................22
Hydroxyproline-beperkt dieet........................................................................................................................22
Vetconstant dieet............................................................................................................................................23
Glucose tolerantietest....................................................................................................................................23
15. Voeding met gewijzigde consistentie...................................................................................................... 23
15.1. Zachte voeding...........................................................................................................................................24
15.2. Half-vloeibare voeding...............................................................................................................................24
15.3. Vloeibare voeding......................................................................................................................................25
1. Algemeen
1.1. BMI
BMI (kg/m2) Risico op co-morbiditeit
Ondergewicht < 18,5 Laag
Normaal gewicht 18,5 – 24,9 Gemiddeld
Overgewicht 25 – 29,9 Licht verhoogd
Obesitas klasse 1 30 – 34,9 Matig verhoogd
Obesitas klasse 2 35 – 39,9 Ernstig verhoogd
Obesitas klasse 3 ≥ 40 Zeer ernstig verhoogd
Co-morbiditeit: ziektes die worden gecreëerd door overgewicht zoals hart- en vaatziekten,
overbelasting (gewrichten), diabetes T2, hypertensie, bepaalde kankers
BMI ouderen: 23-28 = gezond
1.2. Energiebepaling
3
, Formule Henry: gezonde volwassenen, bejaarden, diabetes mellitus, zuigelingen, jonge kinderen,
zwangere of lacterende vrouwen en sporters
PAL x BMR
Formule Harris & Benedict: personen met pathologie
BMR:
Man BMR= 88 + (13,4 x gewicht in kg) + (4,8 x lengte in cm) – (5,7 x leeftijd in jaren) (x 4,2 kJ)
Vrouw BMR= 447 + (9,2 x gewicht in kg) + (3,1 x lengte in cm) – (4,3 x leeftijd in jaren) (x 4,2 kJ)
+ TFF = 10% BMR
+ toeslag lichamelijke activiteit
Bedlegerig +10% BMR
Ambulant +20% BMR
Geringe activiteit +30% BMR
Gemiddelde activiteit +40% BMR
+ toeslag ziekte (metabole stress; niet gebruiken bij brandwonden)
Geen metabole stress +0% BMR
Geringe metabole stress (en/ of + 1oC koorts) +10% BMR
Matige metabole stress (en/ of + 2oC koorts) +20% BMR
Ernstige metabole stress (en/ of + 3oC koorts) +30% BMR
+ gewichtstoename gewenst = 30% BMR
+ brandwonden
10% van het lichaamsoppervlak +25% BMR
25% van het lichaamsoppervlak +50% BMR
> 50% van het lichaamsoppervlak +100% BMR
+ overige factoren
Vasten (zonder metabole stress) - 15% BMR
Longpatiënten (zonder beademing) +15% BMR
Beademing - 10% BMR
Hypertonie +10% BMR
Sedatie of spierverslapping - 10% BMR
2. Energie- en eiwitverrijkt dieet
2.1. Begripsomschrijving en indicaties
4
Inhoudsopgave
1. Algemeen.................................................................................................................................................. 3
1.1. BMI.................................................................................................................................................................3
1.2. Energiebepaling.............................................................................................................................................3
2. Energie- en eiwitverrijkt dieet.................................................................................................................... 4
2.1. Begripsomschrijving en indicaties.................................................................................................................4
2.2. Screeningsmethoden.....................................................................................................................................5
2.3. Doelstellingen dieet.......................................................................................................................................5
2.4. Dieetkenmerken.............................................................................................................................................5
Energie..............................................................................................................................................................5
Eiwitten.............................................................................................................................................................5
Vetten en koolhydraten....................................................................................................................................6
Vitaminen en mineralen...................................................................................................................................6
Vocht en elektrolyten.......................................................................................................................................6
2.5. Praktische uitwerking en tips.........................................................................................................................6
Eiwitten.............................................................................................................................................................6
Vetten................................................................................................................................................................6
Koolhydraten.....................................................................................................................................................7
Vocht.................................................................................................................................................................7
3. Energiebeperkt dieet.................................................................................................................................. 8
3.1. Begripsomschrijving en indicaties.................................................................................................................8
3.2. Doelstellingen................................................................................................................................................8
3.3. Bepaling gewenste gewichtsvermindering....................................................................................................8
3.4. Dieetkenmerken.............................................................................................................................................9
Energie..............................................................................................................................................................9
Eiwitten.............................................................................................................................................................9
Vetten................................................................................................................................................................9
Koolhydraten.....................................................................................................................................................9
Vitaminen en mineralen...................................................................................................................................9
Voedingsvezels..................................................................................................................................................9
Vocht.................................................................................................................................................................9
3.5. Praktische uitwerking en tips.......................................................................................................................10
Vetten.............................................................................................................................................................10
Koolhydraten..................................................................................................................................................10
Alcohol............................................................................................................................................................10
Voedingsvezel.................................................................................................................................................10
Energieruilwaardesysteem.............................................................................................................................10
3.6. Very low calorie diets...................................................................................................................................10
4. Eiwitbeperkt dieet.................................................................................................................................... 11
4.1. Begripsomschrijving en indicaties...............................................................................................................11
4.2. Doelstellingen..............................................................................................................................................11
1
, 4.3. Dieetkenmerken...........................................................................................................................................11
Energie............................................................................................................................................................11
Eiwitten...........................................................................................................................................................11
Koolhydraten en vetten..................................................................................................................................12
Mineralen en spoorelementen.......................................................................................................................13
Vocht...............................................................................................................................................................13
4.4. Praktische uitwerking..................................................................................................................................13
5. Glutenvrij dieet........................................................................................................................................ 13
5.1. Begripsomschrijving en indicaties...............................................................................................................13
5.2. Doelstellingen..............................................................................................................................................13
5.3. Dieetprincipes..............................................................................................................................................14
5.4. Praktische uitwerking..................................................................................................................................14
6. Vetbeperkt dieet...................................................................................................................................... 15
6.1. Begripsomschrijving en indicaties...............................................................................................................15
6.2. Doelstellingen..............................................................................................................................................15
6.3. Dieetkenmerken...........................................................................................................................................15
Vetten.............................................................................................................................................................15
Calcium...........................................................................................................................................................15
Vetoplosbare vitaminen.................................................................................................................................15
7. MKT-dieet................................................................................................................................................ 15
7.1. Begripsomschrijving en indicaties...............................................................................................................15
7.2. Dieetkenmerken...........................................................................................................................................16
Vetten.............................................................................................................................................................16
Vetoplosbare vitaminen.................................................................................................................................16
8. Voedingsvezelverrijkt dieet....................................................................................................................... 16
8.1. Begripsomschrijving en indicaties...............................................................................................................16
8.2. dieetkenmerken...........................................................................................................................................17
Vezels..............................................................................................................................................................17
Vocht...............................................................................................................................................................17
8.3. Praktische uitwerking..................................................................................................................................17
9. Lactosevrij/lactosebeperkt dieet.............................................................................................................. 18
9.1. Begripsomschrijving en indicaties...............................................................................................................18
9.2. Dieetkenmerken...........................................................................................................................................18
Lactose............................................................................................................................................................18
Vitaminen en mineralen.................................................................................................................................18
9.3. Praktische uitwerking..................................................................................................................................19
Lactosebeperkt...............................................................................................................................................19
Lactosevrij.......................................................................................................................................................19
Galactosevrij...................................................................................................................................................19
10. Natriumbeperkt dieet............................................................................................................................. 19
10.1. Begripsomschrijving en indicaties.............................................................................................................19
10.2. doelstellingen.............................................................................................................................................19
2
, 10.3. Dieekenmerken..........................................................................................................................................20
10.4. Praktische uitwerking................................................................................................................................20
11. Kaliumbeperkt dieet............................................................................................................................... 20
11.1. Dieetkenmerken.........................................................................................................................................20
11.2. Praktische uitwerking................................................................................................................................20
12. Vochtbeperkt dieet................................................................................................................................. 20
12.1. Begripsomschrijving en indicaties.............................................................................................................20
12.2. Dieetkenmerken.........................................................................................................................................20
13. Fosfaatbeperkt dieet.............................................................................................................................. 21
13.1. Begripsomschrijving en indicaties.............................................................................................................21
13.2. Dieetkenmerken.........................................................................................................................................21
13.3. Praktische uitwerking................................................................................................................................21
14. Diagnostische diëten.............................................................................................................................. 22
14.1. Eliminatiediëten.........................................................................................................................................22
14.2. Proefdiëten................................................................................................................................................22
14.3. Voorbereidingsdiëten.................................................................................................................................22
Ca-beperkt dieet.............................................................................................................................................22
Hydroxyproline-beperkt dieet........................................................................................................................22
Vetconstant dieet............................................................................................................................................23
Glucose tolerantietest....................................................................................................................................23
15. Voeding met gewijzigde consistentie...................................................................................................... 23
15.1. Zachte voeding...........................................................................................................................................24
15.2. Half-vloeibare voeding...............................................................................................................................24
15.3. Vloeibare voeding......................................................................................................................................25
1. Algemeen
1.1. BMI
BMI (kg/m2) Risico op co-morbiditeit
Ondergewicht < 18,5 Laag
Normaal gewicht 18,5 – 24,9 Gemiddeld
Overgewicht 25 – 29,9 Licht verhoogd
Obesitas klasse 1 30 – 34,9 Matig verhoogd
Obesitas klasse 2 35 – 39,9 Ernstig verhoogd
Obesitas klasse 3 ≥ 40 Zeer ernstig verhoogd
Co-morbiditeit: ziektes die worden gecreëerd door overgewicht zoals hart- en vaatziekten,
overbelasting (gewrichten), diabetes T2, hypertensie, bepaalde kankers
BMI ouderen: 23-28 = gezond
1.2. Energiebepaling
3
, Formule Henry: gezonde volwassenen, bejaarden, diabetes mellitus, zuigelingen, jonge kinderen,
zwangere of lacterende vrouwen en sporters
PAL x BMR
Formule Harris & Benedict: personen met pathologie
BMR:
Man BMR= 88 + (13,4 x gewicht in kg) + (4,8 x lengte in cm) – (5,7 x leeftijd in jaren) (x 4,2 kJ)
Vrouw BMR= 447 + (9,2 x gewicht in kg) + (3,1 x lengte in cm) – (4,3 x leeftijd in jaren) (x 4,2 kJ)
+ TFF = 10% BMR
+ toeslag lichamelijke activiteit
Bedlegerig +10% BMR
Ambulant +20% BMR
Geringe activiteit +30% BMR
Gemiddelde activiteit +40% BMR
+ toeslag ziekte (metabole stress; niet gebruiken bij brandwonden)
Geen metabole stress +0% BMR
Geringe metabole stress (en/ of + 1oC koorts) +10% BMR
Matige metabole stress (en/ of + 2oC koorts) +20% BMR
Ernstige metabole stress (en/ of + 3oC koorts) +30% BMR
+ gewichtstoename gewenst = 30% BMR
+ brandwonden
10% van het lichaamsoppervlak +25% BMR
25% van het lichaamsoppervlak +50% BMR
> 50% van het lichaamsoppervlak +100% BMR
+ overige factoren
Vasten (zonder metabole stress) - 15% BMR
Longpatiënten (zonder beademing) +15% BMR
Beademing - 10% BMR
Hypertonie +10% BMR
Sedatie of spierverslapping - 10% BMR
2. Energie- en eiwitverrijkt dieet
2.1. Begripsomschrijving en indicaties
4
